Healthcare Provider Details

I. General information

NPI: 1366307167
Provider Name (Legal Business Name): WILLOW J SANDERS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/23/2025
Last Update Date: 12/23/2025
Certification Date: 12/23/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

689 CLAUDIUS WAY
WINDSOR CA
95492-8532
US

IV. Provider business mailing address

689 CLAUDIUS WAY
WINDSOR CA
95492-8532
US

V. Phone/Fax

Practice location:
  • Phone: 707-228-2753
  • Fax:
Mailing address:
  • Phone: 707-228-2753
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberAMFT160516
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: